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RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin v.189 no.2, 2017년, pp.128 - 136   SCI SCIE
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Impact of Abdominal Follow-Up Sonography in Trauma Patients Without Abdominal Parenchymal Organ Lesion or?Free Intraabdominal Fluid in Whole-Body Computed Tomography
Nutzen einer abdominellen Verlaufs-Ultraschalluntersuchung bei Traumapatienten ohne Nachweis von Organverletzungen oder freier FlUssigkeit in der initialen Computertomografie

Schneck, Emmanuel (Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Germany ) ; Koch, Christian (Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Germany ) ; Borgards, Mara (Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Germany ) ; Reichert, Martin (Department of General and Thoracic Surgery, Justus-Liebig-University Giessen, Germany ) ; Hecker, Andreas (Department of General and Thoracic Surgery, Justus-Liebig-University Giessen, Germany ) ; Heiß, Christian (Department of Trauma Surgery, Justus-Liebig-University Giessen, Germany ) ; Padberg, Winfried (Department of General and Thoracic Surgery, Justus-Liebig-University Giessen, Germany ) ; Alejandre-Lafont, Enrique (Diagnostic and Interventional Radiology, Justus-Liebig-University Giessen, Germany ) ; Röhrig, Rainer (Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Germany ) ; Krombach, Gabriele Anja (Diagnostic and Interventional Radiology, Justus-Liebig-University Giessen, Germany ) ; Weigand, Markus (Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Germany ) ; Bernhard, Michael (Central Emergency Unit, University Hospital Leipzig, ) ; Roller, Fritz Christian ;
  • 초록  

    Purpose Patients suffering from severe blunt abdominal trauma are challenging because of their need for accurate diagnostic imaging and fast therapeutic action. Whole-body computed tomography (WBCT) is highly sensitive and represents the gold standard in the trauma room diagnostic setting. The aim of our study was to investigate the impact and therapy relevance of abdominal follow-up sonography (AFS) as part of the tertiary trauma survey (TTS) in patients without abdominal parenchymal organ lesions or free abdominal fluid in initial WBCT.Materials and Methods All adult patients without abdominal parenchymal organ lesions or free intraabdominal fluid in the initial WBCT examination, who received AFS within 24 hours after trauma, were included in this retrospective analysis between January 2008 and December 2011.Results 316 patients were analyzed (ISS 10 ± 8, NISS 13 ± 11) according to the inclusion criteria. Overall, only small amounts of free intraabdominal fluid were detected in AFS in 3 patients (0.9 %) and remained without therapeutic consequence. None of the patients died due to intraabdominal bleeding.Conclusion AFS as part of the TTS did not show additional benefits and had no impact on further treatment in patients without abdominal parenchymal organ lesions or free intraabdominal fluid in the initial WBCT examination. We conclude that AFS is not routinely required but should be performed if indicated on a clinical or laboratory basis because of its fast and less invasive character.Key points Citation Format


    Ziel Das Management von Patienten mit schwerem Bauchtrauma ist oft sehr schwierig und erfordert eine mOglichst schnelle akkurate Bildgebung und Behandlung. Die GanzkOrper-Computertomografie (GK-CT) stellt den Goldstandard zur Diagnostik solcher Patienten dar. Ziel unserer Studie war es den Nutzen des Verlaufsultraschalls im Rahmen des „Tertiary Trauma Survey (TTS)“ bei Patienten ohne abdominelle ParenchymorganlAsion oder freie FlUssigkeit im initialen GK-CT zu evaluieren.Material und Methoden In die retrospektive Studie wurden zwischen Januar 2008 und Dezember 2011 alle erwachsenen Patienten ohne ParenchymorganlAsion oder freie FlUssigkeit im initialen GK-CT, die einen Verlaufsultraschall innerhalb von 24 Stunden nach dem Trauma erhielten, eingeschlossen.Ergebnisse Insgesamt 316 Patienten konnten fUr die Analyse herangezogen werden (ISS 10 ± 8, NISS 13 ± 11). Im Verlaufsultraschall zeigten sich bei lediglich 3 Patienten (0,9 %) sehr geringe Mengen an freier FlUssigkeit, welche aber ohne jegliche weitere therapeutische Konsequenz verblieben. Keiner der Patienten starb an einer intraabdominellen Blutung.Schlussfolgerung Der Verlaufsultraschall im Rahmen des TTS zeigte keinen diagnostischen Nutzen und hatte keinen Einfluss auf Patientenfolgebehandlungen bei Traumapatienten ohne Nachweis einer Parenchymorganverletzung oder freier FlUssigkeit im initialen GK-CT. Somit schlussfolgern wir, das ein Verlaufsultraschall bei diesem Patientenkollektiv nicht routinemAßig durchgefUhrt werden sollte, aber jederzeit falls klinisch oder laborchemisch erforderlich auch aufgrund der geringen InvasivitAt und der schnellen VerfUgbarkeit erfolgen kann.Kernaussagen 


  • 주제어

    trauma .   ultrasound .   FAST .   tertiary trauma survey.  

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